The Empowered Reset Programme Application

First name

Last name

Email

Phone

Location & Time Zone

What type of business do you run?

What do you sell & who do you help?

What are you stuck in right now? (Choose up to 3)

Procrastination / avoidance

Burnout / wired-tired / can't switch off

Visibility fear / posting inconsistency

Overworking / perfectionism

People - pleasing / weak boundaries

Undercharging / not asking / sales avoidance

Receiving limits (money, praise, support feels uncomfortable)

Other

Give me the honest version: what do you keep doing (or not doing)?

Why now? What makes this the right time to change the pattern?

Investment

Yes - I am ready to invest £3000 if accepted

Not right now - I'd like another option

Website/IG link (optional)

Important Note: This work isn't crisis support. If you're currently in acute crisis or need urgent mental health support, please contact local services in your area.